Gliederung

Objective: Camptocormia is a rare syndrome, which is defined as an abnormal flexion of the thoracolumbal spine that appears in the upright position and increases during walking. It occurs in Parkinson's disease or Dystonia or it can appear as a primary idiopathic disease. In the literature, data on deep brain stimulation (DBS) for idiopathic primary camptocormia are extremely rare.

Methods: We report on two patients with primary idiopathic camptocormia. The first patient was a 54-year-old woman, who had suffered from camptocormia for 18 months prior to admission. The second patient was a 49-year-old man with a 1-year-history of the disease. Both reported on an acute beginning; no reason could be found and the symptoms were drug-resistant. As a therapeutic trial we performed a bilateral stimulation of the GPI using stereotactic MRI-planning, multiple trajectories for micro-recording and macro stimulation. Surgery was performed under general anesthesia.

Results: A typical GPI pattern was found along the trajectory analog to other dystonic patients. In addition, normal thresholds for motor side effects for an electrode position in the GPI could be detected. After starting permanent stimulation, improvement with up to a complete reduction of the dystonic movement could be achieved after 2 weeks for the first patient as well as 3 days for the second patient, which was sustained throughout the follow-up period of one year and 6 months, respectively.

Conclusions: Our two cases support that deep brain stimulation of the GPI could be an effective method in the treatment of primary camptocormia. More cases have to follow in order to support these findings.